- Public Inspection: HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Increased Risk of Cyber Threats Against Healthcare and Public Health Sector
- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization Program
- Announcing the 2030 Census Disclosure Avoidance Research Program
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- Public Inspection: CMS: Medicare Program: Fiscal Year 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- Public Inspection: CMS: Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- CMS: Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments; and Appeal Rights for Certain Changes in Patient Status; Corrections and Correcting Amendment
- CMS: Request for Information; Health Technology Ecosystem
- CMS: Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments; and Appeal Rights for Certain Changes in Patient Status; Corrections and Correcting Amendment
Appalachian Commission Extends Strategic Plan Through 2021
ARC develops a Strategic Plan every five years with community input from listening sessions, workshops, and other information from the Region. ARC’s current Strategic Plan Envision Appalachia: Community Conversations for ARC’s Strategic Plan technically expired when fiscal year 2020 ended at the end of September. Plans were in the making for a new strategic planning process earlier this year. However, noting challenges related to the COVID-19 crisis, the Commission unanimously voted to extend our strategic plan through fiscal year 2021.
Learn more about ARC’s investment priorities in relation to the extended strategic plan here.
What’s an Opportunity Zone and How Can it Help Your Community?
The ARC hosted a 90-minute Learning Session led by Regional experts about how Appalachian communities can use Opportunity Zones to strengthen local communities. There are 737 distressed communities in Appalachia designed as Opportunity Zones where new investments may be eligible for preferential tax treatment.
The session included remarks from Donna Gambrell of Appalachia Community Capital (ACC) and Alex Flachsbart of Opportunity Alabama (OA), who were recognized recently by Forbes Magazine as visionaries for Opportunity Zones. Using ARC support, ACC is working directly with nearly 20 communities to get them ready for successful Opportunity Zone-driven investments and Opportunity Alabama is developing an Opportunity Zones-based funding and business development ecosystem across Alabama’s 37 Appalachian counties.
The seminar, which included formal presentations and a fireside chat, identified these key steps for successfully implementing Opportunity Zone investment strategies:
- Organize a local ecosystem
- Identify community assets and needs
- Prioritize properties and projects
- Help facilitate connections
Learn more about Opportunity Zones in Appalachia and view the session here.
Trump Administration Finalizes Rule Requiring Health Insurers to Disclose Price and Cost-Sharing Information
The U.S. Departments of Health and Human Services, Labor, and Treasury finalized their tri-agency final rule on healthcare price transparency to further advance the Administration’s commitment to create a healthcare system that is patient and consumer centric. You can learn more about the final rule and the Administration’s transparency efforts by following the links below:
- Read the press release here
- Read more on CMS’s transparency work
- Read a CMS fact sheet on the final rule
- Read the rule
Resource Guide – Promoting Rural Prosperity in America
Building on the foundational work of the Task Force, the White House released a rural prosperity resource guide for State, local, and Tribal leaders. The resource guide – Promoting Rural Prosperity in America – demonstrates the Administration’s historic investment in and support for rural America and outlines key programs across the Federal government to support rural prosperity and resiliency.
You can also find a helpful guide from the White House Office of Intergovernmental Affairs on disaster recovery and resilience here.
Trump Administration Acts to Ensure Coverage of Life-Saving COVID-19 Vaccines & Therapeutics
Trump Administration Acts to Ensure Coverage of Life-Saving COVID-19 Vaccines & Therapeutics
The Centers for Medicare & Medicaid Services (CMS) is taking steps to ensure all Americans, including the nation’s seniors, have access to the coronavirus disease 2019 (COVID-19) vaccine at no cost when it becomes available. Today, the agency released a comprehensive plan with proactive measures to remove regulatory barriers and ensure consistent coverage and payment for the administration of an eventual vaccine for millions of Americans. CMS released a set of toolkits for providers, states and insurers to help the health care system prepare to swiftly administer the vaccine once it is available. These resources are designed to increase the number of providers that can administer the vaccine, ensure adequate reimbursement for administering the vaccine in Medicare, while making it clear to private insurers and Medicaid programs their responsibility to cover the vaccine at no charge to beneficiaries. In addition, CMS is taking action to increase reimbursement for any new COVID-19 treatments that are approved or authorized by the FDA.
Free VA-Approved Health Care and COVID-19 Training Available
The Veterans Health Administration Employee Education System (EES) is a program office of the Department of Veterans Affairs. They provide timely, reliable and essential educational offerings to VA employees and community providers in a variety of easily accessible and cutting-edge formats, much of which offer continuing education credits.
A host of materials have been developed that describe the free training that the VA provides to the public, including:
- A catalog of our current TRAIN educational offerings, which is updated monthly.
- These programs can be accessed anytime through VHA TRAIN
- A subscriber page where learners can sign up by health care topic to get email announcements when courses on a specific topic are added
- VHA TRAIN data sheet, which is a single page PDF of key TRAIN information and can be distributed digitally or printed for local use
The agency has created a COVID-19 training website where any learner can take free COVID-19 specific training. Materials on the site are all available through publicly accessible devices, such as personal cell phones and tablets so they can be taken anytime, anywhere. Here is a data sheet that describes its capabilities.
COVID-19 and Its Impact on Intimate Partner Violence
From the Penn State Center for Health Care and Policy Research
Each year in the United States, nearly 12 million people are the victims of some form of intimate partner violence (IPV) or domestic abuse. Under normal circumstances, IPV is an incredibly difficult public health and socio-judicial issue to address – by nature IPV is “behind closed doors,” and thus, stigma, shame and embarrassment, as well as concerns over safety and privacy, often prohibits individuals experiencing abuse from seeking help . The COVID-19 pandemic has only served to exacerbate this issue by not only increasing the incidence of IPV, but also by adding new challenges and complexities to how services for both victims and their abusers are delivered. In this post, we explore the immediate impact of COVID-19 on IPV rates, the way the pandemic has altered, and in some cases decreased access to, services for victims and perpetrators, and the potential long term implications COVID-19 has on future IPV trends.
New CMS Proposals Streamline Medicare Coverage, Payment, and Coding for Innovative New Technologies and Provide Beneficiaries with Diabetes Access to More Therapy Choices
Durable Medical Equipment (DME) proposed rule would reduce administrative burden for new innovative technologies
On October 27, CMS proposed new changes to Medicare Durable Medical Equipment, Prosthetics, Orthotic Devices, and Supplies (DMEPOS) coverage and payment policies. This rule would provide more choices for beneficiaries with diabetes, while streamlining the process for innovators in getting their technologies approved for coverage, payment, and coding by Medicare.
The proposed rule would expand the interpretation regarding when external infusion pumps are appropriate for use in the home and can be covered as DME under Medicare Part B, increasing access to drug infusion therapy services in the home. The proposed rule also drastically reduces administrative burdens – such as complicated government coverage, payment, and coding processes – that block innovators from getting their products to Medicare beneficiaries in a timely manner. This action aligns with President Trump’s Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors.
“With the policies outlined in this proposed rule, innovators have a much more predictable path to understanding the kinds of products that Medicare will pay for,” said CMS Administrator Seema Verma. “For manufacturers, bringing a new product to market will mean they can get a Medicare payment amount and billing code right off the bat, resulting in quicker access for Medicare beneficiaries to the latest technological advances and the most, cutting-edge devices available. It’s clearly a win-win for patients and innovators alike.”
Due to administrative constraints, the process for making Medicare benefit classifications, pricing determinations, and creating billing codes for DMEPOS used to routinely take up to 18 months to complete. Last year, CMS changed this process through sub-regulatory guidance to reduce that timeframe to six months in many cases, and is now proposing to establish a streamlined process for coding, coverage, and payment in regulation. Under this accelerated process, benefit classification and pricing decisions could happen on the same day the billing codes used for payment of new items take effect, which would facilitate seamless coverage and payment for new DMEPOS and services. If finalized, this proposed rule would allow innovators to bring their products to Medicare beneficiaries quicker giving them more choices and increased access to the latest, cutting-edge devices.
If finalized, this proposed rule will also expand Medicare coverage and payment for Continuous Glucose Monitors (CGMs) that provide critical information on blood glucose levels to help patients with diabetes manage their disease. Currently, CMS only covers therapeutic CGMs or those approved by the FDA for use in making diabetes treatment decisions, such as changing one’s diet or insulin dosage based solely on the readings of the CGM.
CMS is proposing to classify all CGMs (not just limited to therapeutic CGMs) as DME and establish payment amounts for these items and related supplies and accessories. CGMs that are not approved for use in making diabetes treatment decisions can be used to alert beneficiaries about potentially dangerous glucose levels while they sleep and that they should further test their glucose levels using a blood glucose monitor. With one in every three Medicare beneficiaries having diabetes, this proposal would give Medicare beneficiaries and their physicians a wider range of technology and devices to choose from in managing diabetes. This proposal will improve access to these medical technologies and empower patients to make the best health care decisions for themselves.
In addition, the proposed rule would expand classification of external infusion pumps under the DME benefit making home infusion of more drugs possible for beneficiaries. An external infusion pump is a medical device used to deliver fluids such as nutrients or medications into a patient’s body in a controlled manner. The proposal would expand classification of external infusion pumps as DME in cases where assistance from a skilled home infusion therapy supplier is necessary for safe infusion in the home, allowing beneficiaries more choices to get therapies at home instead of traveling to a health care facility.
Lastly, in the proposed rule, CMS proposes to continue to pay higher amounts to suppliers for DMEPOS items and services furnished in rural and non-contiguous areas to encourage suppliers to provide access and choices for beneficiaries living in those areas. CMS is making this proposal based on previous stakeholder feedback that indicate unique challenges and higher costs for providing for DMEPOS items for beneficiaries in rural and remote areas.
For More Information:
New Listserv Topic for Rural Populations
The Centers for Medicare & Medicaid Services (CMS) has a new rural health care listserv dedicated to sharing information about programs, policies and resources to help ensure rural populations have access to quality health care.
To subscribe to the new topic, click here and enter your email! Look for Outreach and Education, then Rural Health.
Our goal at CMS is to develop programs and policies that ensure rural Americans have access to high quality care, support rural providers and not disadvantage them, address the unique economics of providing health care in rural America, and reduce unnecessary burdens in a stretched system to advance our commitment to improving health outcomes for Americans living in rural areas. Rethinking Rural Health is a vital part of CMS’s push to transform the health care delivery system to a model that delivers high quality, affordable, and accessible health care for every American.
Subscribe to the rural health care listserv to receive the latest information and resources on:
- CMS Rural Health Strategy
- Maternal health care
- Payment and billing
- Policies and regulation
- Resources for partners
In order to find more information on rural health activities at CMS, please visit go.cms.gov/ruralhealth or contact RuralHealth@cms.hhs.gov.
‘No Mercy’ Chapter 5: In Rural America, Cancer Care Is Often Far From Home
Where It Hurts Podcast Series, Chapter 5
Sixty-five-year-old Karen Endicott-Coyan is living with a blood cancer. Her chemotherapy takes less than 30 minutes. Before the hospital closed, it was just a short drive into the small town of Fort Scott, Kansas, for her to get treatment.
But these days getting to chemo means a trek on rural roads and narrow highways, driving help from her sister-in-law and some Ritz crackers tucked into her purse to steady her stomach on the way home. The whole trip should take less than three hours. Endicott-Coyan puts on her makeup, her diamond earrings and powers through.
“If I can help it, I’m not going to go over there looking like a sick person,” Endicott-Coyan said. “I don’t like looking like a sick person. That’s just me.”
Endicott-Coyan had a long career in hospital administration, and she uses that expertise to try to smooth out her newly fractured health care. But during every minute of the trip, a nagging worry at home steals her energy and attention. In this chapter of the podcast, host-reporter Sarah Jane Tribble goes along for the ride and is witness to the stress and frustration.
The journey illuminates one reason people in rural America are more likely to die from cancer than patients in metro areas.